Individual
DESIRAEY AMBER BOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6002 N 19TH STREET, BISMARCK, ND 58503
(701) 934-2649
Mailing address
6002 N 19TH ST, BISMARCK, ND 58503-5713
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172A00000X
Driver
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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